Predictors of Burnout Among Physicians: Evidence From a National Study in Portugal

The aims of this research on burnout among physicians were threefold, (1) to characterize the burnout symptoms’ prevalence among Portuguese physicians, (2) to test the hypothesis that organizational demands and resources add, on top of other factors, to the explanatory level of burnout; and (3) to explore the predictors of organizational demands and resources. Data collection was conducted online at the national level in Portugal, with 9,176 complete replies and a response rate of 21%. Predictors stemming from theoretical models of an intra-individual, occupational, organizational, and socio-psychological nature were measured using an online/paper survey. Results were analyzed through a significantly modified version of the Maslach Burnout Inventory (MBI) after transformations to address the fit of this measure in this sample. Results show that 66% of physicians have high levels of emotional exhaustion, 33% high levels of depersonalization, and 39% high levels of decrease of personal accomplishment. Moreover, a first set of hierarchical multiple regression models with burnout symptoms reveals that organizational resources, demands of the relationship with the patients and of work schedule are consistently important predictors of emotional exhaustion and depersonalization on top of other theoretically relevant predictors. A second set of regression models with the organizational-level variables shows that, aside from organizational variables, other context variables, like procedural justice and teamwork, have the most substantial predictive value. These results highlight the importance of recognizing physicians’ burnout as a phenomenon that is predicted by a wide variety of factors, but also the importance of attending to the particular role of circumstancial factors that may be addressed in future interventions.info:eu-repo/semantics/publishedVersio

Robotic process automation : potencial da automação em contexto empresarial

As empresas buscam continuadamente baixar custos e ter aumentos de eficiência para triunfar num ambiente incerto, turbulento e competitivo. As tecnologias da informação são, há décadas, uma das principais estratégias adotadas para atingir estes objetivos. Mas a automação de processos pode ir sempre mais além, articulando melhor diferentes subsistemas, ou acelerando a ligação do analógico ao digital. Neste contexto, o presente estudo procura compreender o impacto destes novos instrumentos, dando especial destaque à automação via RPA (Robotic Process Automation). Genericamente o RPA faz uso de robôs de software de forma a automatizar procedimentos normalmente morosos e repetitivos, permitindo um aumento de produtividade e de eficiência na organização. Para a realização deste estudo recorreu-se a uma metodologia qualitativa, que adotou, como processo de recolha de dados a entrevista semiestruturada, administrada a sujeitos que já estiveram em contacto com ferramentas de RPA na sua atividade profissional. Desta forma, é possível identificar a perceção dos sujeitos da amostra, relativamente a dimensões e atributos desta problemática, identificada em diversos estudos publicados. O estudo exploratório realizado, permitiu concluir, a utilidade das ferramentas de automação robótica de software, com os entrevistados a confirmarem a tendência demonstrada na literatura, nomeadamente referente ao impacto (positivo) na atividade de uma empresa, destacando-se a diminuição dos tempos de processamento e a redução dos erros observados.Companies continually seek to lower costs and increase efficiency in order to triumph in an uncertain, turbulent and competitive environment. Information technologies have been one of the main strategies adopted to achieve these goals for decades. But process automation can always go further, with better articulation between different subsystems, or through accelerating the connection from analog to digital. In this context, the present study seeks to understand the impact of these new instruments, all while giving special emphasis to automation via RPA (Robotic Process Automation). Generally, RPA makes use of software robots in an effort to automate normally time-consuming and repetitive procedures, allowing an increase in productivity and efficiency in the organization. So as to carry out this study, a qualitative methodology was used, which adopted a semi-structured interview as a data collection process, administered to subjects who have already been in contact with RPA tools in their professional activity. Thus, it is possible to identify the perception of the subjects of the sample regarding the dimensions and attributes of this problem, identified in several published studies. The exploratory study carried out allowed us to conclude the usefulness of robotic software automation tools, with the interviewees confirming the trend shown in the literature, namely regarding the (positive) impact on a company's activity, highlighting the decrease in processing speed and the reduction of observed errors

Impact of the Application of Landfill Leachate on the Germination of Senna macranthera in Different Substrates

Landfill leachate is a potential environmental pollutant. Physicochemical analyses allow identifying its elements while the use of ecotoxicological tests aims to understand the relation with the environment. The germination assay of Senna macranthera in different substrates (filter paper, commercial-SCM, conventional-SCV and organic-SOR) was performed with different doses of leachate. The objective was to identify the potential impact of leachate by determining the concentration able to cause inhibition in 50% of the seeds (LC50) and the values of the no observable effect concentration (NOEC) and the lowest observed effect concentration (LOEC). The LC50 and LOEC occurred in the treatments with 6.25 while NOEC was with 3.125%. The test in substrates, It was not possible to identify the LC50 in the SCM. For the SCV was with 66 and in SOR with 25%. The NOEC and LOEC for SCM and SCV were 25 and 50% and in SOR with 50 and 100%.O lixiviado de aterro é um potencial poluente ambiental. Análises físico-químicas permitem identificar seus elementos enquanto o uso de testes ecotoxicológicos visa compreender a relação com o ambiente. O ensaio de germinação de Senna macranthera em diferentes substratos (papel de filtro, comercial-SCM, convencional-SCV e orgânica-SOR) foi realizada com diferentes doses de lixiviado. O objetivo foi identificar o impacto potencial do lixiviado via determinação da concentração capaz de causar inibição em 50% do sementes (CL50) e os valores da concentração de efeito não observável (CENO) e a concentração de efeitos observados (CEO). A CL50 e a CEO ocorreu nos tratamentos com 6,25% enquanto a CENO ocorreu com 3,125%. Não foi possível identificar o CL50 no SCM. Para o SCV ocorreu com 66% e em SOR com 25%. A CENO e CEO para SCM e SCV foram 25% e 50% e em SOR com 50% e 100%

Efeito da homeopatia Ammonium Carbonicum na minimização da lixiviação de nitrato.

Avaliou-se o efeito da solução homeopática Ammonium Carbonicum em duas dinamizações, CH3 e CH30, sobre a lixiviação de NO3 . A hipótese inicial foi a de que essas soluções homeopáticas atuariam na microbiota do solo otimizando a utilização de N pela planta. Esse estudo foi conduzido em casa-de-vegetação e utilizaram-se amostras deformadas do horizonte A de um Latossolo Vermelho distroférrico típico muito argiloso, 0 0,15 m, localizado no campus da UFLA. As colunas de solo foram semeadas com milho (Zea mays L.) e tinham 0,20 x 0,20 m. A irrigação e medição do volume lixiviado foi realizada diariamente. A aplicação dos tratamentos homeopáticos foi realizada via irrigação. As análises do lixiviado foram feitas duas vezes por semana. No lixiviado,mediram-se os teores de NO3 e NH4. Após 93 dias, as colunas foram seccionadas em camadas de 0,05 m e as amostras, analisadas quanto à fertilidade, incluindo NO3 , NH4 e N total. O delineamento experimental foi inteiramente casualizado, com três repetições,num esquema duplo-cego com placebo. O efeito da solução homeopática na minimização da lixiviação de NO3 não foi relevante nas condições deste estudo

Infantile autism and therapeutic process

The purpose of this study is to describe and discuss the therapeutic relationship between a child diagnosed with infantile autism and the psychotherapist. This is a case study that used the clinical-qualitative method and supported from psychodynamically-oriented authors and texts. The clinical material obtained from the eight year-old child's life history and the weekly play therapy conducted over a period of 16 months was discussed and analyzed. An analysis was performed about the therapeutic setting, the I/not I discrimination process, the identity construction process, the patient-therapist relationship, and the function of maternal holding. The fact that a child with autism could establish and develop a relationship with the psychotherapist was fundamental to psychotherapy and psychological development.Objetiva-se descrever e discutir a formação do vínculo terapêutico entre uma criança com diagnóstico de autismo infantil e sua psicoterapeuta. Trata-se de um estudo de caso que utiliza o método clínico-qualitativo, apoiando-se em autores e textos de orientação psicodinâmica. Discute-se e analisa-se o material clínico proveniente da história de vida de uma criança de oito anos de idade, e da psicoterapia lúdica realizada semanalmente, por 16 meses, em um ambulatório público. São comentados alguns aspectos que foram fundamentais para a formação do vínculo, a saber: a configuração do setting terapêutico, o processo de discriminação eu/não-eu, o processo de construção da identidade da criança, a função de holding materno assumida pela psicóloga. O acolhimento da terapeuta foi fundamental para a psicoterapia e para o desenvolvimento psicológico do paciente, permitindo que a criança estabelecesse e desenvolvesse algum tipo de vínculo afetivo.11512

ENVIRONMENTAL IMPACTS CAUSED BY RESIDUAL VEGETABLE OIL IN THE SOIL-PLANT SYSTEM

Vegetable oils are widely used for food production at different levels: domestic, commercial or industrial. The estimated production of vegetable oil, in Brazil, is three billion liters per year. Only 2.5% of cooking oil waste (WCO) are recycled. This paper presents to evaluate the environmental impact of OVR in two Brazilian soils (sandy and loamy) and to estimate the terrestrial toxicity level (leakage test) and phytotoxicity (germination tests using lettuce seeds - Lactuca sativa L. – as well as in lettuce cultivation under greenhouse conditions). After leaching, the sandy soil had a slight lower WCO adsorption capacity than the clayey soil. The introduction of WCO caused clayey soil compaction. The WCO presence was toxic to earthworms, regardless of soil type. WCO negatively influenced germination and radicle growth in the eco toxicity assays. The different tested doses of WCO in lettuce (Lactuca sativa L.) cultivation caused changes in plant morphology for all physical parameters analyzed for both soils. We concluded that the WCO is a potential contaminant residue when improperly disposed over the soil, compromising the soil-plant system.Vegetable oils are widely used for food production at different levels: domestic, commercial or industrial. The estimated production of vegetable oil, in Brazil, is three billion liters per year. Only 2.5% of cooking oil waste (WCO) are recycled. The environmental impacts caused by WCO arrangement in soils still need to be better studied. The interaction of soils and organic pollutants makes it difficult to evaluate its behavior in the environment. This paper presents to evaluate the environmental impact of OVR in two Brazilian soils (sandy and loamy) and to estimate the terrestrial toxicity level (leakage test) and phytotoxicity (germination tests using lettuce seeds - Lactuca sativa L. – as well as in lettuce cultivation under greenhouse conditions). After leaching, the sandy soil had a slight lower WCO adsorption capacity than the clayey soil. The introduction of WCO caused clayey soil compaction. The WCO presence was toxic to earthworms, regardless of soil type. WCO negatively influenced germination and radicle growth in the eco toxicity assays. The different tested doses of WCO in lettuce (Lactuca sativa L.) cultivation caused changes in plant morphology for all physical parameters analyzed for both soils. We concluded that the WCO is a potential contaminant residue when improperly disposed over the soil, compromising the soil-plant system

Ecotoxicological evaluation of the application of landfill leachate on the germination of cabbage (Brassica oleracea var. capitata)

In sanitary landfills occurs the disposal of varied variety of residues that lead to the formation of leachate generated from the decomposition of urban solid wastes. Special attention should be given to leachate, as it may affect natural resources. The adoption of ecotoxicity tests may contribute to understand the relationship of pollutant with the environment in case of disposal or spillage. Thus, germination trials with cabbage (Brassica oleracea var. capitata) submitted to different dosages of landfill leachate (3.125%, 6.25%, 12.5%, 25%, 50% and 100%) were proposed in two substrates: paper filter and soil. The objective of this work was to evaluate the direct and indirect impact of the leachate on the germination of cabbage seeds, through the LC50 and the values of NOEC and LOEC. In both substrates it was not possible to determine the LC50 from the doses tested. In the paper test, the determination of LOEC, occurred with treatment 3.125%. For the soil test, the LOEC value is obtained with the 50% dose. The species presents a high potential for ecotoxicity bioassays to determine environmental impact, due to its sensitivity to variations in the environment

Potencial de aproveitamento da madeira: viabilidade ambiental e comercial na fabricação de briquetes

Inadequate disposal of waste generated during the mechanical processing of wood has caused a series of environmental problems. Awareness of storage and disposal are necessary in order to avoid disposal in nature causing soil contamination and possible environmental impacts. Therefore, it is necessary to develop techniques for their use in order to reduce the pressure on native forests. Thus, the aim of this work is to evaluate is to evaluate the environmental and commercial viability of reusing wood residues in the manufacture of briquettes in the city of Presidente Prudente-SP. The methodology of this research was structured in bibliographic review and field exploration with the cataloging of companies that generate this type of waste, for further investigation of the feasibility of its use in the manufacture of briquettes and, finally, the discussion and analysis of the collected data. Research results point to use of waste, briquettes, as a source of renewable energy, contributing to the environment, generating jobs, reducing visual pollution both in timber yards and in inappropriate disposal sites throughout the city. It is also interesting to point out that waste can be a good deal for the wood sector, as the splitting of wood is enough to manufacture an average of 16,500 kilos of briquettes per month. It is possible to conclude that there is a huge amount of waste generated by the city's wood companies, investigation showed that there is enough demand for implementation of a briquette factory, contributing to the reduction of waste and for more sustainable practices in wood sector. Keywords: Wood waste. Environment. Disposal. Reuse.La inadecuada disposición de los residuos generados durante el procesamiento mecánico de la madera ha provocado una serie de problemas ambientales. Es necesario tener conciencia sobre el almacenamiento y la eliminación para evitar que la eliminación en la naturaleza provoque la contaminación del suelo y posibles impactos ambientales. Por tanto, es requerido desarrollar técnicas para su uso con el fin de reducir la presión sobre los bosques nativos. Así, el objetivo de este trabajo es evaluar la viabilidad ambiental y comercial de la reutilización de residuos de madera en la fabricación de briquetas en la ciudad de Presidente Prudente-SP. La metodología de esta investigación se dividió en revisión de literatura y exploración de campo con la catalogación de empresas generadoras de este tipo de residuos, para profundizar en la investigación de la viabilidad de su uso en la fabricación de briquetas y, finalmente, la discusión y análisis de los datos. Los resultados de la encuesta apuntan al uso de residuos, briquetas, como fuente de energía renovable, contribuyendo al medio ambiente, generando empleos, reduciendo la contaminación visual tanto en los astilleros como en los sitios de disposición inadecuados en toda la ciudad. También es interesante señalar que los residuos pueden ser un buen negocio para el maderero, ya que la división de la madera es suficiente para fabricar un promedio de 16.500 mil kilos de briquetas al mes. Se concluye que existe una enorme cantidad de residuos generados por las empresas madereras en la ciudad, la investigación mostró que existe una demanda suficiente para la implementación de una fábrica de briquetas, contribuyendo a la reducción de residuos y a prácticas más sostenibles en el sector de la madera. Palabras clave: Residuos de madera. Medio ambiente. Descarte. Reutilizar.O descarte inadequado de resíduos gerados durante o processamento mecânico de madeiras vem provocando uma série de problemas ambientais. A conscientização quanto à armazenagem, estocagem e o descarte se faz necessária a fim de evitar o despejo na natureza, provocando a contaminação do solo e possíveis impactos ambientais. Portanto, se faz necessário o desenvolvimento de técnicas para o aproveitamento dos mesmos a fim de reduzir as pressões sobre as florestas nativas. Assim, o objetivo deste trabalho é avaliar a viabilidade ambiental e comercial da reutilização de resíduos da madeira na fabricação de briquetes na cidade de Presidente Prudente-SP. A metodologia desta pesquisa dividiu-se em revisão bibliográfica e exploração de campo com a catalogação das empresas que geram este tipo de resíduo, para posterior averiguação da viabilidade de sua utilização na fabricação de briquetes e, por fim, a discussão e análise dos dados coletados. Os resultados da pesquisa apontam para a utilização dos resíduos, briquetes, como fonte de energia renovável contribuindo com o meio ambiente, geração de empregos, diminuição da poluição visual tanto nos pátios das madeireiras como nos locais de descartes inapropriados espalhados pela cidade. É interessante apresentar ainda que, os resíduos podem ser um bom negócio para o madeireiro, pois o desdobro da madeira é suficiente para a fabricação em média de 16.500 mil quilos de briquetes mês. Conclui-se que existe uma enorme quantidade de resíduos gerados pelas madeireiras do município, a pesquisa demonstrou que há demanda suficiente para implantação de uma fábrica de briquetes, contribuindo para a redução dos resíduos e para práticas mais sustentáveis do setor madeireiro. Palavras-chave: Resíduos de madeira. Meio ambiente. Descarte. Reaproveitamento

Study on the use of Artemia salina as bioindicator in the ecotoxicological evaluation of landfill leachate

Landfill leachate deserves special attention because it presents itself as a potentially polluting liquid that can attack nearby natural resources if it is not carefully treated and disposed of in a controlled manner, or it may be reused in other activities. The present work had the objective of evaluating the toxicity of untreated landfill leachate on the test organism A. salina. The physical chemical characterization of the landfill leachate for the presence of metals and salts was performed according to the methodology proposed by the American Public Health Association - APHA (2005). After hatching, about 10 nauples of A. salina were transferred to 15 x 150 mm test tubes containing 10 mL (saline water and the landfill leach to be tested). Seven treatments with four replicates were used. The LC5048h of the landfill leachate used in the present study was mathematically obtained in the dose with 28.4% of leachate. The parameters of salinity, ammonia and sulfates are directly related to the value of the LC5048h

Distribuição dos casos de cardiopatias congênitas em um hospital do Oeste Paulista

O objetivo deste trabalho foi analisar a distribuição espaço-temporal dos pacientes com cardiopatias congênitas atendidos no Ambulatório de Cardiologia Pediátrica do Hospital de referência do Oeste Paulista. Realizamos um estudo retrospectivo com análise de dados de base eletrônica e prontuários dos pacientes diagnosticados com cardiopatiacongênita entre os períodos de julho de 2013 a julho de 2018. Foram selecionados 298 prontuários para análise das variáveis de CID-10, gênero, distribuição espacial e série temporal. Foi possível observar que os defeitos septais foram as cardiopatias mais prevalentes, não houve diferença entre os gêneros. Notou-se aumento do diagnóstico a partir de 2014, com implementação do teste do coraçãozinho e 51% dos casos eram da cidade de Presidente Prudente,com maior concentração de casos na região do parque industrial. Há uma relação na incidência das malformações cardíacas com o meio ambiente desfavorável. Os resultados encontrados podem guiar políticas de saúde pública, visando reduzir a exposição da população mais vulnerável, na busca da melhora nos índices de saúde.The aim of this research was to conduct a comprehensive spatial-temporal analysis of the population affected by congenital heart anomalies assisted at the Pediatric Cardiology Outpatient Department at the distinguished Western Paulista reference hospital. We conducted a retrospective study involving the analysis of electronic databaserecords and patient medical charts for individuals diagnosed with congenital heart disease during the period from July 2013 to July 2018. A total of 298 medical records were selected for the analysis of variables encompassing the ICD-10 codes, gender, spatial distribution, and temporal trends. It was possible to observe that septal defects were the most prevalent congenital heart abnormalities, and there was no gender-based difference. An increase in diagnoses was noted from 2014, coinciding with the implementation of the “heart test,” and 51% of the cases were from Presidente Prudente, with a higher concentration of cases in the industrial park area. There is an association between cardiac congenital malformations and an adverse environmental context. The findings can inform public health policies aimed at reducing the exposure of the most vulnerable population in pursuit of improvinghealth indicators